Provider Demographics
NPI:1376766840
Name:HAUGAN, LINDSEY OLINE (OTR)
Entity Type:Individual
Prefix:MS
First Name:LINDSEY
Middle Name:OLINE
Last Name:HAUGAN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1233 BELMONTE TER
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32207-3217
Mailing Address - Country:US
Mailing Address - Phone:850-264-5743
Mailing Address - Fax:
Practice Address - Street 1:4600 BEACH BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-4764
Practice Address - Country:US
Practice Address - Phone:904-346-5100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL12687225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist